Nurses Find Success in Growing Field of Medical Cannabis Nursing

Nurses Find Success in Growing Field of Medical Cannabis Nursing

Fame Conway, RN, has seen firsthand how medical cannabis can be a game changer when it comes to fighting chronic illness. Decades of suffering from chronic inflammation and autoimmune disorders made it challenging for Conway to juggle her busy life as an operating room (OR) nurse and mother of two.

Then in 2016, a devastating car accident killed Conway’s son and left her with a femur fracture and an uncertain future.

“After the accident, I suffered from intense pain and Post-Traumatic Stress Disorder (PTSD),” Conway says. “I wasn’t sure if I would ever walk again.”

During her long recovery, Conway began researching the medical uses of cannabis. She was intrigued by research showing how it could ease symptoms ranging from chronic pain to nausea and she felt the knowledge could also benefit her clients.

A member of the Cannabis Nurses Network (CNN), Conway is one of many nurses across the country who is increasing her knowledge of cannabis and its use in modern medicine. As of June 2019, eleven states and Washington, D.C.., have legalized it for recreational use for adults over 21, and 33 states have legalized medical cannabis. Yet regardless of whether a state has enacted legislation, it is estimated that several million Americans currently use cannabis and that it’s a topic that interests many patients.

Conway took online courses through the American Cannabis Nurses Association (ACNA), where she learned about the endocannabinoid system (ECS), a network of receptors that affect appetite, mood, memory, pain, and other physiological functions. Graduates of ACNA’s courses are deemed competent in cannabis nursing.

“The ECS isn’t covered in most nursing programs, but it’s important for nurses to achieve a better understanding of ECS, how it works and how, and why cannabis can be a safe and effective medication,” Conway says.

After adopting a holistic lifestyle that included a plant-based diet and cannabis products when needed to combat pain and PTSD, Conway found she was able to reverse her chronic inflammation and autoimmune diseases in a natural way.

“I learned that whole plant nutrition supplemented with cannabinoids has the ability to regenerate health and restore wellness,” Conway explains. “I’m now able to enjoy an inflammation-free life without taking medication, and I no longer suffer from pain, anxiety, psoriasis, and insomnia.”

Knowing she wanted to help others suffering from autoimmune diseases and chronic inflammation, Conway launched GraceandFame.com, and has created an online health program. She also advises clients on how to adopt a plant-based diet and find the right cannabis product to safely and effectively treat their individual health condition.

 

Helping Women Through Life’s Different Stages

A midwife for over 20 years, Sakina O’Uhuru, CNM, RN, co-founded Black Ash Cannabis in Fort Lee, New Jersey last year after seeing the benefits of CBD oil, which is made by extracting CBD from the cannabis plant, then diluting it with a carrier oil such as hemp seed or coconut.

“CBD oil has been shown to relieve pain, reduce anxiety and depression, and alleviate cancer-related symptoms such as nausea and pain,” O’Uhuru says. “It also helps to reduce symptoms of menopause such as hot flashes, mood swings, and insomnia.”

After seeing the positive effects of CBD oil, O’Uhuru decided to integrate it into her practice. She now sells a CBD oil, derived from hemp plants, that is legal in all 50 states.

“I had clients who were inquiring about the benefits of cannabis and I wanted to be able to answer their questions and address their health needs,” says O’Uhuru, who proceeded to take online cannabis education classes and join the CNN prior to launching Black Ash Cannabis. “I think it’s important for nurses to be able to answer questions about medical cannabis, proper dosing, and the different methods that can be used to administer cannabis that include smoking, edibles, and tincture forms (that work sublingually by applying a drop under your tongue).”

O’Uhuru has worked as a midwife for over 20 years and is the author of Journey to Birth: The Story of a Midwife’s Journey and a Reflection of the Heroic Women She Served Along the Way.

“I work with women of all ages, through childbearing age to menopause,” O’Uhuru says. “I see my training as a cannabis nurse as another part of the cornucopia of services I offer my clients.”

 

Resources for the Canna-Curious


The American Cannabis Nurses Association (ACNA) is currently the only professional nursing organization working towards being recognized by the American Nurses Association as a certifiable nursing sub-specialty. In conjunction with The Medical Cannabis Institute, ACNA offers an online course for nurses, as well as resources for nurses who want to learn more about medical cannabis and how it can be safely and effectively used to manage a patient’s health condition.

Patients Out of Time is a non-profit educational charity dedicated to educating health care professionals and the general public about the therapeutic use of cannabis and the ECS system. They hold an annual conference and offer educational resources and information on their site.

The Cannabis Nurses Network was formed in 2015 and offers professional development courses networking, professional recognition, and legal and medical advocacy.

Cansoom offers nurses and other medical professionals classes to become medical cannabis consultants. Founded by Lolita Korneagay, MBA, BSN, RN, Cansoom courses equip nurses with the knowledge they need to assist patients in consuming cannabis safely and effectively.

Cannabis Education Comes Full Circle

Vanessa Cruz, LPN, of Pueblo, Colorado, has always embraced traditional alternatives in health care. As a master herbalist and end-of-life doula, Cruz thought adding cannabis nurse to her extensive resume was a natural progression.

“I’ve been a nurse for over 15 years and have worked in hospice, home care, and in a hospital setting,” Cruz says. “In home care, I encountered a lot of patients who had heard about medical cannabis and had a lot of questions about whether it might benefit their health condition.”

Cruz took over 30 hours of continuing education courses through the ACNA and discovered that medical cannabis had the potential to treat a number of health conditions. She also joined the CNN to network with other nurses who had an interest in the field.

“As an end-of-life doula, I’ve found many patients who prefer medical cannabis over morphine because it can combat their pain with fewer side effects,” Cruz says. “It also helps patients who are terminally-ill and may be experiencing anxiety or nausea as a side effect of cancer treatments.”

While opioids can produce side effects such as constipation and nausea, and prolonged use can lead to addiction in some cases, Cruz says patients view cannabis as a more holistic alternative. She now offers paid consultations to clients through her business, Traditional Holistic Care.

“I meet with patients who are seeking direction on state-approved medical diagnoses for medical cannabis and have questions on how to obtain a medical cannabis card, and the right product and dosage for their medical condition,” Cruz says. “I’ve seen the potential cannabis has in treating seizure disorders [and] muscle spasms, such as those associated with multiple sclerosis.”

As it continues to grow in popularity, Cruz encourages all nurses to gain an understanding of the field and expand their knowledge of what it means to be a cannabis nurse.

“At some point, all nurses are going to encounter a patient who is using cannabis,” Cruz says. “It’s important for them to be able to determine if there are any potential cannabis-prescription drug interactions [and] how they can answer a patient’s questions and ensure the safe use of cannabis.”

 

Helping Patients Become Cannabis Confident

In Honolulu, Hawaii, Me Fuimaono-Poe, FNP-BC, serves as owner of the Malie Cannabis Clinic, a medical practice that provides marijuana education evaluations, education, and electronic approval for medical marijuana cards.

“We see patients with a wide variety of qualifying conditions, with the most common being pain,” Fuimaono-Poe says. “My youngest patient is about three months old and my oldest patient is 103.”

Fuimaono-Poe first became interested in cannabis after meeting Dennis Peron in 1997 at the first Cannabis Buyers Club in San Francisco. Peron, an American activist and businessman, was an early leader in the fight to legalize cannabis.

Her interest led her to take online classes through the ACNA and the CNN.

“I also attended several cannabis conferences throughout the United States so I can stay up on the latest research,” Fuimaono-Poe says. “There’s currently no certification for a cannabis nurse, but we’re working to change that. The ACNA has been actively involved in getting cannabis nursing to be seen as a nursing sub-specialty in the same way as diabetes, oncology, and critical care.”

In 2016, Fuimaono-Poe, who had previously worked in both a hospital and family medical practice, opened the Malie Cannabis Clinic, dedicated to educating patients about medical marijuana. She notes that even in states where medical cannabis isn’t yet legal, patients have questions about how cannabis might have the potential to help their specific health condition.

And since many dispensaries don’t have nurses on staff, nurses can counsel patients on potential drug interactions and how cannabis used in liquid form or through vaping, might be used as an effective replacement for opioids.

“We educate patients at every appointment on topics such as dosing information based on symptoms and side effects,” Fuimaono-Poe says. “If patients are prepared for the possibility of side effects, I feel like it decreases their fear around using cannabis.”

While acknowledging that on the whole medical cannabis is a safe and effective option, Fuimaono-Poe and her staff tell patients there’s a small risk of side effects.

“If medical marijuana patients stand up too quickly, they can get dizzy, so we let them know that that’s a possibility, and advise them to get up slowly,” she says. “Dry mouth can also be a side effect, so it’s important to stay hydrated and use an over-the-counter product dry mouth product such as Biotene if it becomes worse.”

Fuimaono-Poe believes all nurses should have a working knowledge of cannabis therapeutics.

“Nurses are educators, advocates, and caregivers, which make them a natural fit in the cannabis space,” Fuimaono-Poe says. “Some nurses work in dispensaries, some as health education consultants, and others actually cultivate cannabis.”

Looking to the future, Fuimaono-Poe says her hope is that cannabis nursing will soon become a sub-specialty and that one day in the near future there will be at least one cannabis nurse in every medical setting.

“I see cannabis nurses working in a position similar to a diabetes education nurse and helping to train both other staff members and patients on how to use cannabis safely and effectively,” she says. “Nurses are great at taking complex information and explaining it in terms that all patients can understand.”

It Takes a Village: Nurses Work to Provide Culturally Competent LGBTQ Care

It Takes a Village: Nurses Work to Provide Culturally Competent LGBTQ Care

As a gay man, Austin Nation, PhD, RN, PHN, understands the health care barriers faced by many lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients. As a nurse and educator, he’s working to increase awareness and address the health disparities that continue to exist in the LGBTQ community.

An assistant professor of nursing at California State University, Fullerton (CSUF), Nation lived through the 1980s AIDS crisis, and has worked with many patients in the HIV/AIDS community. While he acknowledges an HIV diagnosis is no longer a death sentence thanks to increased funding and better treatment, Nation has also seen how young gay black and Latino men continue to be disproportionately affected by HIV/AIDS. The Centers for Disease Control and Prevention (CDC) report that 1 in 2 black men and 1 in 4 Latino men will be diagnosed with HIV during their lifetime.

“We’re not reaching all of the people we need to reach,” Nation says. “In order to get to zero new HIV infections, we need to figure out how to engage these populations.”

While treatments have transformed HIV into a chronic but manageable illness, many people are not aware of how prevention efforts that use antiretroviral treatment, and pre-exposure prophylaxis (PReP), an HIV-medication that when taken consistently, can lower the risk of getting infected by more than 90%. Despite being widely available, the CDC notes that while two-thirds of the people who could benefit from PrEP are black or Latino, they account for the smallest amount of prescriptions to date.

To that end, Nation has worked to address the tenuous relationship many people of color and members of the LGBTQ community have with the health care system. Statistics from the Kaiser Family Foundation show that LGBTQ patients often face challenges and barriers in accessing health services including stigma, discrimination, the provision of substandard care, and outright denial of care because of their sexual orientation or gender identity.

“I’ve led LGBTQ cultural competency trainings to teach nurses and nursing students how to provide inclusive services and care for LGBTQ patients,” Nation says. “By knowing whether a patient is gay, lesbian, transgender, straight, or bisexual, and how to best communicate, nurses can identify potential health disparities and care for their patients more effectively.”

On the CSUF campus, Nation has also been a part of the university’s Faculty Noon Time Talks, discussing health care disparities within the African American community. In addition, he is working with faith leaders to adopt a more inclusive environment for LGBTQ individuals who may be reluctant to come out and subsequently don’t receive HIV testing or prevention counseling.

“I also teach a public health course at CSUF where we discuss vulnerable patient populations including the LGBTQ community,” Nation says. “I try to integrate real-world experiences into the course curriculum.”

Nation believes that all nurses can help to achieve diversity and meaningful inclusion, whether they are part of the LGBTQ community or an ally. “Have a voice and be an advocate,” he says. “One person can make a difference.”

Navigating Cancer Care with LGBTQ Patients

As an oncology nurse and LGBTQ advocate, Megan Ober, RN, MS, BSN, OCN, a case manager at the Palliative Care Clinic at the UC Davis Comprehensive Cancer Center in Davis, California, often finds herself bridging the gap between providers and LGBTQ patients.

“Many health care providers work under the assumption that all patients are heterosexual,” says Ober. “It’s important to create a welcoming environment for LGBTQ patients in order to educate them on cancer risk factors and ensure they receive preventative screenings.”

Ober says LGBTQ patients often feel they are being judged and are reluctant to share their sexual orientation or gender identity out of fear of being turned away from health care providers. This distrust can lead to some LGBTQ not seeing a doctor regularly for check-ups and screenings, delaying diagnoses and not receiving information on treatments that might help either their physical or emotional health.

Over the years, Ober has given presentations to staff on LGBTQ disparities in cancer care and risk factors that lead to greater cancer incidence and later-stage diagnoses. These disparities include:

  • Anal cancer. It’s rare in the general population, but 34 times more prevalent in gay men.
  • Cancer screenings. According to the American Cancer Society, lesbians and bisexual women get less routine health screenings than other women including breast, colon, and cervical cancer screening tests.
  • Breast cancer. Lesbian women have higher rates for breast cancer including nulliparity (never having given birth), alcohol and tobacco use, and obesity.
  • Cervical cancer in transgender men. Since most transgender men retain their cervixes, they are also at risk of cervical cancer but are much less likely to obtain Pap smears and regular cancer screenings.

 

Resources to Bring Better Care to LGBTQ Patients

For nurses who want to educate themselves further about LGBTQ health topics, the following information can help:

  • Lavender Health has held virtual coffee hours for nurses working with LGBTQ populations. Their website offers events, resources, and more to help both providers and members of the LGBTQ community promote wellness.
  • The National Resource Center on LGBT Aging offers cultural competency training for staff at nursing homes and others who care for seniors. They also have downloadable guides on creating an inclusive environment for LGBTQ seniors.
  • The U.S. Department of Health and Human Services offers a free downloadable guide, Top Health Issues for LGBT Populations Information and Resource Kit.
  • On a national level, organizations such as the National Alliance of State and Territorial AIDS Directors (NASTAD) has partnered with the Health Resources and Services Administration’s HIV/AIDS Bureau (HRSA-HAB) to launch HisHealth.org, a free online tool that helps nurses and other medical staff learn how to engage HIV-positive young black LGBTQ patients and young black transgender patients by taking a whole-health approach to wellness.
  • Organizations such as the Human Rights Campaign and their Healthcare Equality Index can help with training and best practices such as making changes to electronic medical records and hospital paperwork to incorporate sexual orientation and gender identity and criteria that hospitals can use to become Equality Leaders.
  • The National LGBT Health Education Center has a free downloadable guide, “Providing Inclusive Services and Care for LGBT People: A Guide for Health Care Staff.” The guide discusses using preferred pronouns and preferred names, understanding diversity and fluidity of expression, making LGBTQ patients feel comfortable, common health issues among the LGBTQ population, and much more.

While it can be difficult for nurses to begin a conversation about a patient’s sexuality and sexual health, Ober says it’s important for providers to ask in order to care appropriately for LGBTQ patients.

“Rather than assuming all patients are heterosexual, I recommend nurses introduce themselves and ask a patient how they would like to be addressed, their chosen name, and their preferred pronoun,” Ober says. “There’s a great training video on YouTube called ‘To Treat Me You Have to Know Who I Am’ that showcases a mandatory employee training program that was launched for health care providers in New York.”

Ober also cautions against assuming the personal info on a patient’s chart is correct. Often, people who are transgender may identify as a different gender than the one listed on their electronic medical record.

“Rather than greeting a patient with a title such as Mr. or Ms., I encourage nurses to ask patients how they would like to be addressed,” Ober says. “Shifting from a heteronormative model to one that is more inclusive acknowledges that patients and families aren’t all the same. The woman sitting by your patient’s bedside may be her wife, rather than her sister or friend.”

Nurses Lead the Way with Change

Caitlin Stover, PhD, RN, chair of the national Gay and Lesbian Medical Association (GLMA) Nursing group says both nurses who identify as LGBTQ and those who are allies can work to create an inclusive environment for LGBTQ patients.

“I’m an ally that joined GLMA and now I’m chair of the organization,” Stover says. “There are so many resources out there that can help nurses become better patient advocates and deliver culturally sensitive care to LGBTQ patients.”

Stover says while many nurses across the country are doing great work in creating an inclusive environment in their hospital units and establishing trust and rapport with LGBTQ patients, there are still many nurses and providers who have not received education on LGBTQ health issues.

“It’s important for nurses to strip themselves of preconceived notions, judgements, and assumptions,” Stover says. “Our job is to provide the best possible care, regardless of a patient’s age, ethnicity, gender, or sexual orientation.”

She cites the Guidelines for Care of Lesbian, Gay, Bisexual, and Transgender Patients downloadable PDF created by GLMA as a good starting point for nurses who are seeking advice on how to communicate with LGBTQ patients using sensitive language. The document also includes guidelines for forms, patient-provider discussions, and more.

Continued Education Leads to Better Health Outcomes

Learning about LGBTQ patients isn’t a topic that is always covered in nursing school. A national survey conducted in 2014 found that 43% of nursing faculty who taught in bachelor’s degree programs across the United States reported limited or somewhat limited knowledge of LGBTQ health. Between 23-63% of respondents indicated either never or seldom teaching LGBTQ health, although a majority of respondents felt LGBTQ health should be integrated into the nursing courses they teach.

In 2013, Columbia University Medical Center in New York launched the LGBT Health Initiative, based at the Division of Gender, Sexuality, and Health at the New York State Psychiatric Institute and the Columbia University Department of Psychiatry in association with the Columbia University School of Nursing. The goal of the initiative is to bring together research, clinical care, education, and policy to fight stigma and improve the health of the LGBTQ community.

Janejira J. Chaiyasit, DNP, AGNP-C, an assistant professor at Columbia University School of Nursing and a nurse practitioner at ColumbiaDoctors Primary Care Nurse Practitioner Group, says students at the Columbia School of Nursing receive training on LGBTQ cultural competency as part of their studies.

“We highlight the unique health disparities, risks, and health needs of the LGBTQ patient population to increase awareness, so that our future providers and care takers will offer appropriate care and ask the right questions,” Chaiyasit says.

At Columbia, Chaiyasit has seen how promoting inclusivity and culturally competent care has led to better patient care and health outcomes, and how training staff and students adequately prepares them to care for LGBTQ patients.

“If a patient doesn’t feel comfortable, how can we expect them to divulge their personal health concerns to us, and, in return, enable us to give them the best care?” Chaiyasit says.

And despite progress that has been made nationally, Chaiyasit says there’s a continued need for nurses to learn about the differing health needs of the LGBTQ community.

“LGBTQ patients have a lot of health disparities and changing the preconceptions of health care delivery for this community is a way to close the gaps—reducing ER visits, reducing the time to access health care for medical and psychosocial issues, and increasing the rate of preventative health screenings,” Chaiyasit says. “For example, many health care professionals are unaware of the health needs for trans patients, specifically these patients’ needs for transition-specific hormone therapy care and maintenance to achieve the desired gender features. This is really important as it impacts physical and mental health as a whole.”

In addition to nurses becoming more aware of gender-neutral language, many hospitals have begun customizing their patient intake forms to ensure they are LGBTQ-inclusive.

“At Columbia, we piloted intake form questions, which were ultimately implemented across the Nurse Practice Group, that allow patients to select, or even write in, their preferred gender identity pronouns,” Chaiyasit says. “A complete patient history helps to ensure each patient gets the care and services they need.”

Minority Nurse Inventors: Improving Patient Care Through Unique Clinical Solutions

Minority Nurse Inventors: Improving Patient Care Through Unique Clinical Solutions

Ernesto Holguin, RN, BSN, CNN, dialysis clinical coordinator at Las Palmas Medical Center in El Paso, Texas, was saddened to see his elderly patient arrive for her dialysis appointment in 2003 with a foot infection caused by a diabetic ulcer.

“Diabetes had affected her eyesight and caused her to lose feeling in her feet,” says Holguin. “It was only when she smelled a foul odor emanating from her foot that she realized something was wrong.”

Wishing there was a tool that could assist diabetic ­patients in preventing foot ­ulcers from ­developing, Holguin decided to invent a device.

Holguin is one of many nurses across the country who have envisioned inventions they ­believe will help improve ­patient care. One of the earliest nurse inventors, Bessie Blount Griffin, an African American nurse, invented a feeding tube during World War II to help feed paralyzed veterans. Since then, many more nurses have tapped into their natural problem-­solving skills to invent ­devices to ­improve the patient ­experience.

Ernesto Holguin, RN, BSN, CNN

For Holguin, that meant finding a way for patients to avoid diabetic foot ulcers or in the event they did develop a foot ulcer, to prevent it from becoming infected. The American Podiatric Medical Association (APMA) says that foot ulcers are one of the most common complications in patients with diabetes and if not treated properly, can lead to infections and in some cases, diabetes-related amputation. According to the APMA, foot ulcers occur in approximately 15% of diabetic patients and are commonly located on the bottom of the foot. Among patients who develop a foot ulcer, 6% will be hospitalized due to infection or ulcer-related complications, and 14–24% of patients with diabetes who develop a foot ulcer will ­require an amputation.

“The current protocol for prevention of diabetic foot ­ulcers involves patients ­checking their feet on a daily basis for cuts, cracks, blisters, and signs of an open wound,” ­Holguin says. “Patients who have trouble viewing the bottom of their feet are often told to stand over a mirror at home, but this can be difficult for patients who are overweight, arthritic, or elderly and don’t have good balance.”

Holguin envisioned a ­device that patients would use at home to prevent and effectively monitor their diabetic foot ulcers. The apparatus would inspect, dry, and take pictures of a patient’s feet and then send that information to their clinician.

His idea began to gain traction in 2007 when the first iPhone was released, and the idea of doing remote patient consults became a distinct possibility. In 2015, Holguin was invited to a workshop that the MakerNurse program was holding in Texas. Founded in 2013, MakerNurse works with nurses to bring their ideas for inventions to fruition, believing the best ideas for patient care are often developed by those on the front lines who work directly with patients.

“I told Anna Young and Jose Gomez-Marquez, the cofounders of MakerNurse, about my invention and they were very enthusiastic and encouraged me to build a prototype,” ­Holguin recalls. “Even though I’ve always liked to tinker, I never imagined I would one day design and build a device that could help my patients.”

Gomez-Marquez says MakerNurse launched in 2013 with support from the ­Robert Wood Johnson Foundation. MakerNurse provides the tools, platform, and training to help nurses like Holguin make the next generation of health technology. Two years ago, MakerNurse partnered with the ­University of Texas Medical Branch at Galveston to open their first MakerHealth Space in John Healy Hospital.

“Too often nurses have a great idea on how to but aren’t sure how to make it a reality,” says Gomez-Marquez. “We encourage nurses who have an idea for an invention to build a ­prototype and run with their idea.”

Working out of his garage in El Paso, Holguin recently finished the fourth prototype for his device. The first three he says were too large and cumbersome for patients to use. The U.S. Patent and ­Trademark Office recently certified ­Holguin’s patent, and is now working with a local medical incubator to turn his idea into a medical grade device.

“The next step is to have the device tested in clinical trials, and if successful, to submit it to the Food and Drug Administration (FDA) for approval,” ­Holguin explains. “I’ve talked with several doctors who believe my invention could be part of an important part of a diabetic patient’s treatment plan.”

In addition to making it easier for diabetic patients to monitor their feet for foot ulcers, Holguin believes his invention would reduce ­hospital readmissions. And more importantly, it could also help patients maintain a better quality of life.

“Some diabetics are only in their forties or fifties when an infected foot ulcer leads to amputation and disability,” says Holguin. “I’m confident this device can help diabetic patients to remain employed and live fulfilling lives.”

 

Making Your Idea Reality

Do you have an invention you think would improve ­patient care? Here are some tips on how to get started.


Conduct Due Diligence

It’s ­important to research whether there are any similar products in development, and also to decide whether you want to sell your idea to a company or to start your own business. Organizations such as the Small Business Administration can help you with these decisions.


Design a Prototype

Ideas are great, but you need to have something tangible to demonstrate how your invention works. MakerNurse can help nurses learn how to sketch and design a prototype and test out their ideas.


Seek out Support

MakerNurse has MakerHealth Spaces across the country that provides nurses with direct access to tools, materials, and expertise to build prototypes and test their ideas. Interested hospitals can host a MakerNurse workshop or invest in a MakerHealth program for their hospital. Visit MakerNurse.com to learn more.

Additionally, companies like Edison National Medical lend their expertise to help inventors to make their ideas a reality. The company says inventors will never pay more than $25 so it’s low-risk.


Consider a Patent

After you’ve developed a prototype for your idea, consider getting a patent to protect your invention. Visit the U.S. Patent and Trademark Office.

Nurses as Makers

Roxanna Reyna, BSN, RNC-NIC, WCC

Roxanna Reyna, BSN, RNC-NIC, WCC, a wound care coordinator at Driscoll Children’s Hospital in Corpus Christi, Texas, calls herself “MacGyver Nurse.” True to her moniker, she invented a unique skin and wound dressing for infants with abdominal wall defects.

Reyna’s workplace, Driscoll Children’s Hospital, was one of five “expedition sites” initially launched at hospitals in California, New York, and Texas, by MakerNurse.

Reyna got the idea to make a dressing for children born with omphalocele, a type of birth defect that leaves intestines protruding from the body and covered only by a thin layer of tissue. Surgery repairs the defect, but in the interim, the infant is at risk of infection.

“There weren’t any ­dressings or bandages made for kids that provided the same level of healing,” says Reyna. “So, I started experimenting with bandages, sponges, and tape.”

Reyna’s invention not only helped her colleague and young patients, but she was also invited to the White House in 2014 to meet ­President Obama and to take part in an event honoring “makers.”

Since Reyna’s product is tailored to a specific group of ­patients and there’s not enough demand for it to be manufactured on a large-scale basis, she did make directions on how to construct her dressing through MakerNurse.


A Path of Beauty

Monique Rodriguez

Monique Rodriguez was working as a labor and delivery nurse in Indiana when she ­decided to launch her own beauty company, Mielle ­Organics.

“While looking for natural solutions for my own hair challenges, I began creating products in my kitchen and blog about my hair journey on social media,” says ­Rodriguez. “I gained an audience and people began to

ask if they could purchase my concoctions. A light bulb went off and Mielle Organics was born.”

Rodriquez initially stayed in her nursing job to save money to fund the company.

“I strongly believe in speaking things into existence. I wrote my resignation letter in May and dated for November and was actually able to quit my job sooner,” she says.

Although she had little entrepreneurial experience when she started her company, ­Rodriguez did have drive and determination. In an effort to learn as much as she could, Rodriguez read books, listened to podcasts, and scoured the Internet to obtain as much information as possible.

“When I launched my business in 2014, natural hair products for black hair was an emerging market and I was attempting to stay on the cutting edge,” she says. “Today, the market is much more competitive, and although there’s room for all brands to succeed, we strive to be number one.”

Rodriguez, who worked as a nurse for nine years, says one of the biggest barriers she faced in launching her own business was not letting fear overcome her.

“It was very scary leaving my career as a RN, because of the fear of the unknown,” says Rodriguez. “I also wish that I had a business mentor or someone to talk with in the beginning.”

Rodriguez says her ­background in nursing also proved helpful in developing the ­Mielle Organics line.

“I understood the importance of using high quality ingredients that are effective for hair growth,” she says. “When we formulate our products, we don’t just focus on hair care, but also how healthy are the ingredients.”

Today, Rodriquez leads a corporate staff of 13 and her business is thriving. Mielle Organics are now sold at Sally Beauty, Target, and CVS ­locations.


An Invention Leads to a New Business

Lisa Vallino, RN, BSN

Lisa Vallino, RN, BSN, still remembers when she and her nurse colleagues would turn plastic cups into makeshift intravenous (IV) covers for their pediatric patients. Although it worked to prevent patients from accidentally dislodging their IVs, Vallino thought there had to be a ­better way.

“Nurses are inventors by nature,” says Vallino. “I looked at these IV cups we were using to keep our young patients from snagging and pulling out their IV tubing, and it occurred to me that someone should invent a pre-cut IV insertion site cover.”

Vallino mentioned the idea to her mother Betty Rozier, and the two worked to design their own version of an IV site protector. They started with a specimen cup and tweaked the dimensions into a prototype they called “IV House.”

“The first feedback we received from nurses was that the device was too big,” says Vallino. “We went back to the drawing board and made a smaller size, as well as providing ventilation so we weren’t providing a warm, dark, and moist environment under the IV House.”

She and her mom then worked with a plastics manufacturer to produce the product in bulk.

“The first attempt was a disaster,” explains Vallino. “The manufacturer delivered the IV House shipment to the hospital without labels and we also discovered the finished product was full of flaws.”

The experience taught ­Vallino to fully vet and test a prototype with a manufacturer before committing to the process. While continuing to work as a nurse, Vallino spent her off hours developing her invention.

“We started with the UltraDome for pediatric patients, a clear, plastic IV site protector designed to shield, secure, and stabilize the catheter hub and loop of tubing at an IV insertion site,” says Vallino. “Since then, we’ve invented a new and improved UltraDome that is used in hospitals around the world.”

Since her first invention, Vallino has gone on to develop 19 other products under the IV House name and to also work with other nurses to develop their inventions.

“Several years ago, a nurse friend had an idea for an invention that I bought,” says Vallino. “That idea resulted in the new TLC UltraSplint, featuring an ergonomic design and see-through openings. We found that with traditional arm boards there were injuries occurring that could be avoided.”

Vallino says she still hears from a lot of nurses who have ideas for inventions. Many just want to know if their idea is viable. After signing a nondisclosure agreement, Vallino offers feedback on the ideas, and for those that show promise, she encourages those nurses to find the right buyer.

“Our business is concentrating on working to create the most effective and highest quality products available to IV therapy patients,” says Vallino. “In addition to maintaining our current products, I have ideas for an additional five to six inventions I’d like to roll out in the near future.”

Online Versus Traditional Nursing Education: Which Program Meets Your Needs?

Over the last decade, there has been talk of an impending shortage of nurses. Even in light of the economic downturn, the soaring demand for more educated nurses is expected to continue as baby boomers age and health care coverage expands. For nurses who are entering or are in the field already, this demand presents an excellent opportunity to advance their careers and expand their knowledge.

So what is the logical next step? Often, it is to obtain an advanced degree. Once the decision to pursue higher education has been made, the next question is where to enroll. As online degree programs have increased in popularity over the last few years, many prospective students may wonder about the similarities and differences between online and traditional nursing programs. Before making your decision, consider what type of institution and program will best suit your needs and situation.

Benefits of an online education

Many nurses say the primary reason they chose an online program is because of the convenience and flexibility. Online learning offers students who are trying to balance a family, career, and other commitments the opportunity to earn a degree without sacrificing their other interests and obligations. An online nursing program may also offer a wider variety of degrees than a local university—if a local university is even an option. Especially in rural areas, the distance and time to travel to a brick-and-mortar institution may make this option impractical.

Another benefit of online learning is the asynchronous environment. In an asynchronous learning environment, students can participate at their convenience instead of being limited to participating at the designated location and the time when a class is offered. In the online format, students can generally post their homework and contribute to discussions when it works best for them. This is an especially important benefit to nurses who work shifts that potentially preclude them from attending traditional classes.

Some nurses believe that enrolling in an online program means losing out on the networking and interaction opportunities that occur in a traditional classroom. While it is true that actual face-to-face interaction is limited, nurses still have the opportunity to connect and network with other professionals online. The online setting also allows students to network with classmates and faculty from across the country and potentially around the world. As a result, nurses have the opportunity to hear about what’s happening beyond their local area, as well as benefit from the practical experience and knowledge shared by colleagues in other locations. The ability to connect with professionals from different practice settings and to share experiences and challenges is also cited as a unique feature of online learning. And other student resources, such as career advisement and even tech support, are typically as accessible and readily available via online universities as traditional.

Face time

While it may be the solution for some, online learning isn’t for everyone. There are students who want or need a traditional learning environment. For instance, an online classroom lacks the nonverbal cues that visual learners prefer. Some students simply need the face-to-face interaction. Many feel most comfortable having conversations in person and not over the phone or via an online discussion.

In addition, online and traditional nursing programs have different communication styles. On the job, nurses are taught to be succinct in their writing style because of the volume of required documentation in electronic records and because much of their work is done via checklists. Nurses who choose online education participate in a more intensive writing program than traditional education offers, since nearly all of the communication online occurs in written form. Prospective students should keep their personal communication style and preferred learning format in mind when selecting a program.

For both traditional and online nursing programs, practicum or clinical experience is required. However, practicum arrangements vary by degree program as well as by institution. Undergraduate practicums in face-to-face programs are usually arranged by the institution, while undergraduates in online programs typically propose the facility and preceptor. For graduate practicums, the trend for both online and face-to-face programs is for the student to propose their facility and preceptor.

No back row

Class participation is a very different dynamic in an online program versus a traditional program. In a traditional classroom, faculty members typically lecture, and grades are often based on exams and papers rather than on classroom participation. On the other hand, an online program places greater emphasis on participation: everyone participates in discussions by posting their thoughts—there is no back row.

The asynchronous online environment is an unexpected benefit for many students, because it allows students to think about what they want to say before they actually say it. Online students have time to reflect on the discussion, and they are actually more engaged. Traditional students who fear public speaking tend to stay silent in class, whereas an online setting can help build confidence in shy individuals or help those for whom English is a second language compose their thoughts before speaking.

Above all else, quality

Regardless of the delivery method, it is important that students find a quality nursing program. When researching which program or type of institution is best, one of the first things prospective students should check is the accreditation. The program should be accredited by either the National League for Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE). Additionally, the school should also have a Higher Learning Commission (HLC) accreditation if it offers doctoral programs, as Ph.D. programs are not NLNAC- or CCNE-accredited.

Another consideration when choosing a nursing program is to look at the level of faculty preparation and experience. Faculty credentials are important, and faculty members should be teaching in their areas of expertise—as established through both academic preparation and experience. Faculty members should be experts, and they should be certified in their areas of practice.

For an online nursing program in particular, it is important to see how long the institution has been in the business of teaching and offering classes online. Many schools are now offering classes online, but that doesn’t mean that their classes are designed for a truly online experience. To provide a high-quality online nursing program, it is necessary for the school to have expert instructional-design knowledge as well as the technology support that online students need.

Above all, prospective nursing students need to be diligent and research the institution. Talk to an enrollment advisor about the program and the various resources available. Also, reach out to faculty members and current students, as well as alumni who have gone through the program. Ask them questions about their experience, course content, and how the degree has helped them succeed. Prospective students can also check out benchmarks with the American Distance Education Consortium (ADEC), the American Federation of Teachers (AFT), and the National Education Association (NEA) to see if the institution they are interested in enrolling in is meeting those benchmarks.

At the end of the day, there is no significant difference between student outcomes for traditional and online nursing programs. Both can provide a rewarding learning experience, but, ultimately, it is up to the student to determine which program and delivery method are best suited to his or her current situation and needs.

How to Choose a Nursing School: From Traditional to Online and Accelerated Programs

How to Choose a Nursing School: From Traditional to Online and Accelerated Programs

With over 2,000 nursing schools in the United States, it can be challenging to determine which nursing program will meet your specific needs. In addition to traditional nursing programs that meet on campus, there has been a significant increase in the number of accelerated and online nursing programs being offered across the country.

The American Association of Colleges of Nursing (AACN) says accelerated programs for non-nursing graduates have gained momentum as colleges work to meet the Institute of Medicine’s call to increase the proportion of nurses with baccalaureate degrees to 80% by 2020. According to AACN statistics, research has shown that lower mortality rates, fewer medication errors, and positive outcomes are all linked to nurses prepared at the baccalaureate and graduate degree levels.

“I believe the BSN should be the minimum requirement for entry to practice for all nurses,” says Monica McLemore, PhD, MPH, RN, an assistant professor of family health care nursing at the University of California, San Francisco. “Science moves too quickly for nurses not to have a broad set of skills that are included in the four-year degree. I also believe nurses need to advance their education and to plan for this advancement in the context of the rest of their lives.”

Choosing an Accelerated or Online Nursing Program

The Saint Louis University School of Nursing introduced the first accelerated BSN program in the country, says Teri A. Murray, PhD, APHN-BC, RN, FAAN, dean of the school of nursing. The 12-month program was launched in 1971 for students with a non-nursing bachelor’s degree who were interested in pursuing an RN license and a BSN degree. The university also offers a 21-month accelerated MSN program.

For those with a prior degree, accelerated nursing programs offer the fastest path to becoming a registered nurse with programs generally running 12 to 18 months long. The Saint Louis University RN-to-BSN program can be completed in three full semesters and also offers clinical experiences at top hospitals and a simulation laboratory.

“We need more baccalaureate-prepared nurses from diverse backgrounds,” says Murray. “The United States Department of Health and Human Services says there are approximately three million RNs living in the U.S. Of those, 16.8% identified as belonging to a racial and/or ethnic minority, which remains far removed from the 28% diversity of the general population.”

For registered nurses who are looking to earn their bachelor’s degrees, many colleges have begun offering RN-to-BSN programs. Oregon Health and Science University (OHSU) in Portland, Oregon, is one such college that offers an online RN-to-BSN program.

“Our online BS-RN program focuses on leadership, population-based community care, and evidence-based practice,” says Glenise McKenzie, PhD, RN, an associate professor and the RN-to-BSN program director at the OHSU School of Nursing. “In our Leadership courses, students learn how to analyze systems-level data and improve health care delivery through the development of a quality and/or process change project. In Population-Based Health, students focus on community and public health nursing, incorporating social, environmental, and cultural assessments into the care of a selected population in a non-acute care setting.”

McKenzie says the OHSU online program utilizes a variety of teaching and learning strategies throughout courses, including: voice-to-voice webinars; voice-over lectures; small online asynchronous and synchronous group discussions; online group projects and presentations; one in-person conference (two days with public health and community assessment focus, including a simulated cultural diversity experience); individual written assignments; online quizzes; and guided learning activities focused on application of health and wellness concepts.
Kamala Basak, RN, who works as nurse manager at the Tri-City Health Clinic in Fremont, California, is currently enrolled in an online RN-to-BSN program through Grand Canyon University in Phoenix, Arizona.

“In the RN-to-BSN program, I’ve learned how to lead a team instead of just managing my staff,” says Basak. “In addition, being able to study and research on my own helps me learn the material in a better way—and that is why I prefer learning online. In this program, even though we do not see our classmates, we still communicate and work together to complete our group projects.”

Going Beyond the Bachelor’s Degree

Elizabeth Florez, PhD, RN, assistant professor at the DePaul University School of Nursing in Chicago, Illinois, strongly encourages aspiring nurses not only to obtain their BSN, but also to continue on to get an advanced degree. Nurses with a graduate education provide direct patient care at an advanced level, conduct research, teach, impact public policy, lead health systems, and more.

“Many hospitals will now only hire BSN-prepared nurses or require diploma nurses already working in the hospital setting to go back to school to obtain a BSN,” Florez says.

Florez notes that aspiring nurses who already have a non-nursing bachelor’s degree can also apply to a generalist in nursing master’s program where they will obtain a master’s degree and they will be able to sit for the National Council Licensure Examination (NCLEX) board exam.

“Obtaining a master’s degree in nursing offers many additional benefits for advancement once the nurse has sufficient nursing experience,” Florez says.

And it’s never too late to go back to school to obtain an advanced nursing degree. McLemore went to nursing school right out of high school at the age of 17, but completed her PhD program at the age of 40.

“I wish I had entered graduate school sooner than I did [six years after completing my BSN],” she says. “I plan a long research, teaching, and clinical career.”

Murray also completed her doctorate program just as she was approaching her 40th birthday.

“Had I known the benefits of doctoral education, I would have started immediately after completing my BSN,” Murray says. “This would have given me a longer time to make strong contributions to advancing the field of nursing. Nursing is a wonderful field, and there are many expanded opportunities that come with graduate education at the MSN, DNP, or PhD level.”

Florez says there is a great need for more nursing professors overall, but especially nursing professors from minority backgrounds.

“Master’s degree students are encouraged to seek clinical instructor positions once they obtain sufficient nursing experience, and they are also encouraged to continue their advanced education to the doctorate in nursing practice or PhD level to obtain a faculty position,” says Florez. “Currently, DePaul University has a Bridges to PhD program, which is a National Institutes of Health funded grant program affiliated with the University of Illinois at Chicago. That program is meant to increase the number of minority faculty with a PhD.”

Eligible DePaul nursing students enrolled in the master’s entry to nursing practice program are able to apply to the Bridges to PhD program, and qualified students will then be provided many resources and support to ensure they are adequately prepared for the PhD program.

Making Nursing School Affordable

While the cost of an education can be a barrier for many nurses, experts say there are many scholarships and financial incentives available that can help to make nursing school more affordable.

Students should never assume they can’t afford a specific nursing school, says Aara Amidi-Nouri, PhD, RN, associate professor, chair of the BSN program, and director of diversity at Samuel Merritt University School of Nursing in Oakland, California.

“I see far too many high school students who incorrectly assume they can’t attend private nursing schools, when they could easily qualify for financial aid,” says Amidi-Nouri. “My recommendation is for students to widen the net and examine their options before committing to a particular program.”

And although the Free Application for Federal Student Aid (FAFSA) is available January 1, many students don’t apply until the last minute. This doesn’t give them enough time to complete the process, and can also prevent them from obtaining certain grants and scholarships offered on a first-come, first-served basis. Other students don’t know financial aid is an option, or believe they won’t qualify because of their income.

“Students should always apply for FAFSA to receive financial aid but also look into scholarship opportunities,” says Florez. “Some colleges or universities may offer internal scholarships; however, students should also be encouraged to seek outside scholarships, such as through minority nursing associations, professional nursing organizations, and state/national scholarship programs.”

In addition, Florez notes that many nursing organizations will allow students to become student members, thus offering them additional mentorship and financial support.

“There is even more financial assistance available for minority students seeking a PhD in nursing through grants, fellowships, and teaching/research assistant positions,” says Florez. “Once students complete their nursing program and begin working in the field, they may qualify for loan repayment programs such as the one offered through the Health Resources and Services Administration that pay back a portion of nursing loan debt for registered nurses working in hospitals and clinics that care for underserved, underinsured, and uninsured populations.”

Many nursing schools, including the St. Louis University School of Nursing, are making a concentrated effort to attract more minority and male nursing students.

“For the past six years, we’ve been the proud recipient of the Robert Wood Johnson Foundation New Careers in Nursing Scholarship,” Murray says. “This scholarship program is directed toward underrepresented students, which include males and minorities, for entry into the accelerated program in an effort to diversify the nursing profession.”

What to Look For in a Nursing School

Amidi-Nouri says choosing a nursing school depends a lot on a student’s goals and where they are in the process. A high school student may choose a different program than a paraprofessional (CNA, LVN) who is already working in the field.

“If you’re looking at an RN program, such as an ADN, check to see if the school has a joint program with a BSN program, or whether you will have to reapply to an RN-BSN program to obtain your BSN,” suggests Amidi-Nouri.

Amidi-Nouri encourages prospective students to consider the following when choosing a nursing program:

•    What is the nursing school’s graduation rate?

•    What is the NCLEX pass rate?

•    What is the local reputation of the school?

•    What commitment does the school make to diversity (e.g., mission statement, vision statement, course offerings, diversity office)?

•    What are the values of the school of nursing and of the university?

•    What kind of academic support is available? Tutoring? Mentoring?

•    How long is the program and what are the different pathways to get there?

•    Are the faculty bios on the website? Do you see that faculty are diverse and/or have interest in diversity and health disparities?

•    Is there a part-time option? If so, how long will that take?

•    Are there information sessions, either live or virtual, that can tell you more about the program?

“Technology is important and students should seek programs that have vast resources in terms of a skills lab,” says Mona Clayton, RN, BSN, an author and nurse from Lakewood, California, who completed nursing school as a single mother, and now encourages other single mothers to enter the nursing profession in her “Surviving the Journey” seminars. “Finding schools that are associated with “magnet” hospitals, accredited by the American Nurses Credentialing Center, is a plus.”

Magnet hospitals are recognized for having better nursing environments, promoting excellence in nursing practice, and providing high quality patient care.

“Use the Board of Registered Nursing website as a resource for finding schools with top-notch passage rates for the National Council Licensure Examination (NCLEX-RN) exams,” Clayton says. “I also encourage single parents and working students to seek out programs that are flexible and offer weekend and evening classes.”

Murray advises minority students to also seek institutions with a welcoming campus atmosphere and a mix of diverse individuals (e.g., faculty, students, and staff).

“Often when there are only a handful of diverse individuals, students voice concerns related to feelings of isolation, alienation, and loneliness,” Murray says. “The student should determine if the institution’s leadership supports a diverse and inclusive climate evidenced by proactive actions, policies, and services that support this belief.”

Students should also ensure the nursing school they choose to attend is accredited by the Commission on Collegiate Nursing Education or the National League for Nursing Accrediting Commission.

“Accreditation is important for making sure the nursing school has met the state requirements to be able to take the national board exam,” Murray says. “Minority students should select a nursing program that has additional support for students to be successful. The additional support might be in the form of a nursing student organization, mentor/mentee program, tutoring, open lab hours, success coaches, et cetera.”